The common and modifiable nature of many cardiovascular and metabolic risk factors, especially hypertension, and obesity, makes them excellent targets for prevention of and intervention for cognitive and functional impairment and dementia and mortality. Vascular and metabolic conditions are more common and more likely to be under-diagnosed and untreated in Mexican Americans, leading to more severe disease, poorer survival and greater risk of dementia and cognitive and functional decline. This study will evaluate the long-term effects of metabolic and vascular risk factors on cognition, function and mortality in a 10 year study of 1,789 older Mexican Americans. It will address the role of social and cultural factors in this context. Study results will have implications for prevention of late life impairments that will be applicable beyond this particular ethnic group. Our aims address two sets of related risk factors: body composition and blood pressure. This project takes advantage of a unique collaboration between investigators at the University of Michigan, School of Public Health, Departments of Epidemiology and Biostatistics and the UC Davis Alzheimer's Center and the Younkin Lab at Mayo Clinic Florida. AIM 1. Evaluate the effects of change over time in systolic and diastolic blood pressure, peripheral vascular disease and within-person blood pressure variability on study outcomes. AIM 2. Evaluate the effects of body composition and changes in body composition on study outcomes. AIM 3. Evaluate biological mediators of the association between vascular and metabolic conditions and study outcomes. AIM 4. Evaluate the association of blood pressure and body composition to MRI-measured global and regional atrophy, abnormal white matter (WMH) signals and infarcts as links to dementia and cognitive and functional impairment. AIM 5. Evaluate social and cultural factors and how they are biologically mediated in relation to study outcomes. PUBLIC HEALTH RELEVANCE: This study will evaluate the long-term effects of obesity and hypertension cognition, function and mortality in a 10 year study of 1,789 older Mexican Americans. It will address the role of social and cultural factors in this context. Study results will have implications for prevention of late life impairments that will be applicable beyond this particular ethnic group.